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mHealth Group Wants to Define Store-And-Forward Telehealth

A group formed by ACT | The App Association has proposed a definition of 'asynchronous' telehealth, in hopes of settling debates over how it is regulated and reimbursed.

- mHealth proponents have drafted a definition for “asynchronous” telehealth, and they’re hoping federal officials will use it when dealing with MACRA issues and CPT codes.

The Connected Health Initiative (CHI), a group organized by ACT | The App Association, has released a definition and four uses cases for asynchronous – also called store-and-forward – telehealth, noting that existing definitions “are inconsistent and have unfortunately led to confusion and in some cases has limited the ability of American patients to leverage the most effective technological solutions available in their treatments.”

An ideal example of that lies in Arkansas, where the state’s medical board has included language in proposed telehealth regulations that specifically exclude online questionnaires from the store-and-forward definition. The issue hampers telehealth vendors like Teladoc, which does a majority of its business via phone.

The CHI is recommending that asynchronous of store-and-forward be defined as “the sharing of data from one party to another through the use of a device or software that records, stores, and then sends such data via any communications or technological means.”

The group, noting this is the first in a number of “consensus document(s) capturing key connected health terminology and relationships amongst and between these terms,” is hoping the American Medical Association’s CPT Telehealth Services Working Group recognizes the CHI’s definition of store-and-forward telehealth during its ongoing effort to update the CPT coding system.

Likewise, the CHI is hoping the Centers for Medicare & Medicaid Services takes note.

CMS “continues to restrict Medicare reimbursable ‘telehealth’ services to ‘multimedia communications equipment that includes, at a minimum, audio and video equipment permitting two-way, real-time interactive communication,’” the CHI wrote. “Recently, the Medicare and CHIP Reauthorization Act (MACRA) has instructed CMS to incorporate ‘telehealth and remote patient monitoring’ into the new value-based system. The CPT process is well-positioned to contribute to the accurate capture of medical practices that include these new tools, including asynchronous/store and forward technology.”

This could be the first of several less-than-concrete phrases or terms addressed by the CHI. In an environment where physician adoption and reimbursement is tied to varying definitions of telehealth, telemedicine, digital health, mHealth, eHealth, connected health, electronic health, health and wellness and mobile health, the industry could use a common phraseology.

Another example pops up in Arkansas and several other states, as well as CMS’ own regulations on telemedicine delivery. Some organizations define the “originating site” for a telehealth encounter as a healthcare location, such as a doctor’s office, hospital or clinic. This often eliminates remote patient monitoring programs that take place in the patient’s home, businesses that offer telehealth services to their employees through kiosks or a platform access on mobile devices, and direct-to-consumer platforms accessible via mobile devices.

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